The need for increased academic physician-scientists in Pediatric Critical Care Medicine, and collaborative rigorous investigation of new treatment modalities with focus on pathobiology and long-term morbidities, is clear. This renewal application requests the resources to continue our four-year post-doctoral research training program in Pediatric Critical Care Medicine within the Department of Pediatrics at the University of California, San Francisco. The goal of the program, which began in 2006, is to increase the number of highly trained, successfully funded and sustainable pediatric critical care physician-scientists, who will perform high level laboratory and/or clinical-translational research that will ultimately improve our understanding of the pathobiology of critical illness, improve short and long-term outcomes, and reduce the incidence of children with residual disabilities and/or chronic disease. To this end, this program aims to provide comprehensive science training and mentoring career development for pediatricians with an M.D. or M.D./Ph.D. degree who commit themselves to an academic career with a strong research component. The key elements of the training program are (1) a mentored research experience, (2) scientific course work, (3) career development workshops, (4) interdisciplinary experiences, (5) continuing review and evaluation. The centerpiece of the program is the continuation of a 4-year fellowship training program, with two years devoted to intense research training in basic laboratory science, clinical-translational science, or epidemiology related to pediatric critical care disease. A large number of exceptionally qualified faculty have committed their support as mentors for fellows supported by the proposed training grant. These faculty are affiliated with several of the UCSF campuses and organized research units and programs, which include the Cardiovascular Research Institute, the Dept. of Epidemiology and Biostatistics, the Program in Biological Sciences, and several UCSF clinical campuses including UCSF Benioff Children's Hospitals in San Francisco and Oakland, and SF General Hospital. All fellows will take courses in (1) Responsible conduct in research, (2) Scientific writing and (3) Art of lecturing. A Trainees Mentoring Program will support post-doctoral fellows in their training and career development. Fellows will be matched with three faculty mentors on entry into their training; the mentors will meet with the fellow on a regular basis, to assist him/her in setting and monitoring training and career goals. The program has a strong track record in recruiting and training pediatric sub-specialists. Of the 6 trainees who have completed their training, 4 have been awarded NIH K awards (67%), and the trainee finishing in June has been awarded an AHA Fellow-to-Faculty Transition Award. All have academic faculty appointments. Thus, the rationale for this renewal is based on the well-documented need for well-designed training programs to prepare pediatric-scientists for a sustained productive career in Pediatric Critical Care research and the fact that UCSF has the vision, experience and infrastructure to train the next generation of leaders in pediatric science.